Pharm Exam II Flashcards
Which of the following is a symptom of acute cholinergic toxicity?
Bradycardia
(Muscarinic symptoms)
-SLUDGE: Salivation, Lacrimation, Urination, Diarrhea, GI discomfort, Emesis
-DUMBBLESS: Diarrhea, Urination, Miosis, Bronchorrhea, Bradycarida, Emesis, Lacrimataion, Salivation, Sweating
(Nicotinic symptoms)
-muscle cramps
-tachycardia
-weakness
-twitching
-fascultations
A drug that has an effect of increased gastric emptying:
Increased absorption
GI absorption is ______ by meds that inhibit gastric emptying (example: atropine, anticholinergic, opiates)
slowed
GI absorption is _______ by meds that increase gastric emptying (example: metoclopramide, Reglan)
increased
- Competition for protein binding sites
- Alterations in “free” drug concentrations
- Impact secondarily on elimination
These describe:
Distribution
- Enzyme induction (Phenytoin, Carbamazepine, Rifampin, Theophylline)
- Enzyme inhibition (Allopurinol, Ciprofolxacin, Paroxetine, Fluoxetine, Cimetidine)
These describe:
Metabolism
- Tubular secretion
- Altered urine flow and urine pH
These describe:
Excretion
What ions are associated with phase 0?
Na
What ions are associated with phase 1?
Na
What ions are associated with phase 2?
Ca
What ions are associated with phase 3?
Ca & K+
What ions are associated with phase 4?
Ca
What phase of cardiac action potential is being described?
RAPID DEPOLARIZATION, sodium channels open
Phase 0
What phase of cardiac action potential is being described?
PARTIAL REPOLARIZATION, sodium channels close
Phase 1
What phase of cardiac action potential is being described?
PLATEAU, calcium channels open
Phase 2
What phase of cardiac action potential is being described?
REPOLARIZATION, calcium channels close, potassium channels open
Phase 3
What phase of cardiac action potential is being described?
PACEMAKER/RESTING, degradation of membrane potential, slowly calcium channels
Phase 4
Refractory period in which the heart CANNOT be stimulated:
Absolute
Refractory period in which a greater than normal stimulus may initiate a response:
Relative
Which of the following medications has a high risk of QT prolongation & TDP?
-Amiodarone
-Bretylium
-Dofetillide
-Ilbutilide
-Dronedarone
-Sotalol
A BIG DOG IS DARN SCARY
What is TDP?
Torsades de Pointes- a specific type of ventricular tachycardia that begins in your heart ventricles
Which of the following is an “irreversible” indirect cholinergic agent?
-Novachok agents
(organophosphates which include novachok agents, insecticides, & nerve agents)
Which of the following is an arrhythmia that results in a HR of less than 60 BPM?
Bradycardia
(Tachycardia is greater than 100 BPM)
Vaughn-Williams classifies:
Antiarrhythmic medications
List the following Vaughn-Williams classifications:
Class I:
Class II:
Class III:
Class IV:
Class V:
Class I: Na+ channel blockers
Class II: Beta-adrenoreceptor blockers
Class III: K+ channel blockers
Class IV: Ca++ channel blockers
Class V: Miscellaneous
Which receptor minimizes the potential for dry mouth?
M3- glandular/smooth muscle; gastric acid, salivary secretion, GI contraction, occular accommodation, vasodilation
Which is a neurohormone?
Epinephrine
neurohormone: any hormone produced and released by neuroendocrine cells into the blood
Which of the following drugs causes dry mouth & urinary hesitancy?
Disopyramide (norpace)
(This is Class Ia antiarrhythmic mediation)
-also causes constipation & QT prolongation